Dr. Waleed Abd EL-Hamid Hassan Gives Guidelines
By Francesca Sullivan
Ramadan is just around the corner and for many children it will be a time for the new experience of fasting. In preparation for this important life induction, Cairo West Magazine spoke with a leading paediatrician on when, how and with what precautions we should introduce this important and meaningful part of the Muslim calendar to our children.
Dr. Waleed Abd EL-Hamid Hassan is a paediatrician specializing in nutrition, working at the Center For Social and Preventative Medicine (CSPM), which is a division of the Abo Elrish Children's Hospital. He is also head of the Malnutrition Paediatric Clinic.
Just this year, Dr. Waleed opened his own private practice, Kids’ Care Clinic, at Medipoint, Sheik Zayed.
CWM: Which age is the best for a child to start fasting?
WH: Children are required to fast from the age of puberty, and this is not harmful. Fasting prior to this age is tolerated differently depending on the child’s general health, nutrition and attitude. Fasting prior to the age of seven or eight years is not advisable, although it is a good idea to make young children aware of the practice of fasting in the community around them, and to give them a ‘taste’ of fasting, for example for a few hours at a time.
Dehydration during Ramadan is a big factor to consider, what can help to make it better?
Harmful levels of water loss could occur if the child is poorly hydrated before commencing the fast, and/or could be made worse by activities during the day and weather conditions. If your child produces very little or no urine, feels disorientated and confused, or faints due to dehydration, the fast should be broken in order to rehydrate him.
It is recommended to drink an average of eight glasses of water between iftar and sohoor meals, though the child should not drink in excess at the iftar meal. It’s better to take one to two cups every two to three hours. Other good fluids for the body are unsweetened juices, milk or butter milk, and soup, but limit them to one cup/day, as they provide extra calories. If your child is combatting overweight, these can be in a low fat form.
What are the most important things to consider in children's food plans in Ramadan?
Even though the Ramadan diet may contain overall less than a child’s normal amount of food, if it is sufficiently balanced it will keep him/her healthy and active throughout the month. The diet should be simple and not differ too much from the year-round diet, containing foods from all the major food groups and dairy.
Divide meals into three (iftar, midnight, sohoor), and delay the sohoor meal to Fajir time (as close to sunrise as permitted).
Iftar is the meal which breaks the day’s fast. This meal could include dates, following the Prophet's traditions. Dates will provide a refreshing burst of much-needed energy.
Fruit juices will also have a similar, revitalizing effect. The meal should remain a meal and not become a feast! Try to minimize the rich, special dishes that traditionally celebrate the fast.
Complex carbohydrates are important foods that help release energy slowly during the long hours of fasting. They are found in foods such as barley, wheat, oats, millet, semolina, beans, lentils, whole meal flour and basmati rice, and must be included in the Ramadan diet. The same goes for fiber-rich foods which are also digested slowly and include bran, cereals, whole wheat, grains and seeds, potatoes with the skin on, vegetables such as green beans, and almost all fruit, including apricots, prunes and figs.
How can you guide a child to stick to healthy eating during Ramadan?
Start gradually
To begin with, try out partial fasts during the day. Let them "fast" from breakfast till lunch, for example, then gradually increase this so they can get used to the idea as they get older. Children who can manage it may be able to fast entire days, possibly just the weekends if school days are too tiring.
Reward
A tangible reward for their efforts during Ramadan can help encourage their spirit. Try creating a chart with stickers to mark out the days they fast, or give them a small gift of some sort to acknowledge their daily attempts.
Distract them
Do not force children to fast the entire day if they are struggling, as there is no obligation for them to do so. Do try and distract them for as long as you think appropriate, especially just before iftar when the smell of food may tempt them.
Feed them wisely
While there may be a temptation to "reward" children who attempt to fast with their favorite meals and treats, this could do them more harm than good. Excessively sugary and fatty foods will not benefit their health during Ramadan. Aim for a well-balanced meal to provide long-lasting energy for children who are fasting (see nutritional guidelines above) and remember to control their portions of sweets and caffeinated drinks.
Change their habits
Just as we adults try to reform our lives and character, so too should our children. Try to change your children's daily activities to be more in keeping with Islam. Restrict movies, cartoons, iPads and TV games etc. and instead encourage them to read Islamic stories or listen to Qur'an. While these habits may be difficult to maintain after Ramadan, at least make it clear to the children that things need to be different during the month.
Company
Try and take your fasting children to visit their young friends who are also fasting. This will help build a companionship and can help them encourage one another.
What are essential food items that a child should have every day for sohoor?
Consume more protein at the sohoor meal, such as low fat cheese, labnah, peanut butter, (low fat) yogurt, or milk.
Consume more slow-digesting foods at the sohoor meal, such as cheese, labnah, yogurt, lentils, beans, oatmeal, peanut butter, dried fruits, and lean meat.
Increase your fiber intake at the sohoor meal, such as whole wheat bread, legumes, salads, vegetables, and dried fruit.
How can you keep children to a sensible eating and lifestyle plan during Ramadan?
Talk to your child about the benefits of eating well and looking after their body especially during Ramadan. Health is generally not a priority for children so focus on other ways of connecting it to issues that are important to them.
For example, for teenage girls explain that a healthy diet during Ramadan will give them glowing skin, shiny hair and strong nails, give them more energy to go shopping with their friends and help them concentrate so they’ll perform better in their favorite subjects at school.
For boys, explain that eating well during Ramadan will help to build and tone muscles, give them great skin and help them do well in their favorite sports.
Which foods should be avoided if a child is fasting?
Foods to avoid are the heavily processed, fast-burning foods that contain refined carbohydrates in the form of sugar, white flour, etc., as well as, of course, too much fatty food (eg. cakes, biscuits, chocolates and sweets). It may also be worth avoiding the caffeine content in drinks such as tea, coffee and cola. Avoid Deep-fried foods. Reduce intake of sweets (such as jello, jam, honey, pudding, sugary drinks); sweets do not satisfy hunger for long.
‘Kids’ Care’ offers preventive and wellness care, developmental screening, immunization and treatment of acute illness, as well as professional nutritional assessment of infants, children and adolescents.
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